Individual provider Active NPI

Amanda Arieux Roberts-Garcia, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Titusville, FL
National Provider Identifier
1104622125
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11037855 Issued in FL
Practice address
1453 Wakefield Ter
Titusville, FL 32796-1652
Phone
(321) 626-2241
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 11037855 FL Primary

Addresses

Primary practice location

1453 Wakefield Ter
Titusville, FL 32796-1652

Mailing address

1453 Wakefield Ter
Titusville, FL 32796-1652
Phone (321) 626-2241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250323000015 FL Practitioner - Nurse Practitioner 9931621612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11037855FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Luisa Vega DNP LLC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1104622125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 WAKEFIELD TER",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961652",
            "telephone_number": "321-626-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 WAKEFIELD TER",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961652",
            "telephone_number": "321-626-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-GARCIA",
        "first_name": "AMANDA",
        "middle_name": "ARIEUX",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11037855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.